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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Metoprolol Necessary To Take Inspite Of Having High BP?

I ve been prescribed 25 mg of metoprolol. No high bp, BMI 21, wt well into normal range, a1c is 6.2. I do not want to start the med & become full blown diabetic as other family members are. I do have some irreg. heart beat & PVC. Am I doing myself harm by not taking metoprolol? Female 60+
Mon, 3 Nov 2014
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Internal Medicine Specialist,  's  Response

Thank you for your query. I can understand your concerns.
Asymptomatic PVCs (Premature Ventricular Complexes )require no therapy.
Beta-blockers e.g.metoprolol can be used to treat symptomatic patients.
Beta-blockers with intrinsic sympathomimetic activity may be particularly helpful.Metoprolol is without intrinsic sympathomimetic activity (ISA).
Beta blocker drugs may increase blood sugar levels in those who don't have diabetes.New onset diabetes is more likely to occur during treatment with metoprolol.
VPCs of sufficient frequency can cause a reversible cardiomyopathy.In the absence of structural heart disease, VPCs do not appear to have prognostic significance.
Antiarrhythmic drug therapy that slows myocardial conduction can actually increase the risk of life-threatening arrhythmias (drug-induced QT prolongation and TDP) despite being effective at eliminating VPCs.
These are the pros and cons of treatment of PVCs. However each case is an individual problem and therapy needs to be decided by the concerned cardiologist.







Regards

Dr. T.K. Biswas M.D.
Mumbai
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Is Metoprolol Necessary To Take Inspite Of Having High BP?

Thank you for your query. I can understand your concerns. Asymptomatic PVCs (Premature Ventricular Complexes )require no therapy. Beta-blockers e.g.metoprolol can be used to treat symptomatic patients. Beta-blockers with intrinsic sympathomimetic activity may be particularly helpful.Metoprolol is without intrinsic sympathomimetic activity (ISA). Beta blocker drugs may increase blood sugar levels in those who don t have diabetes.New onset diabetes is more likely to occur during treatment with metoprolol. VPCs of sufficient frequency can cause a reversible cardiomyopathy.In the absence of structural heart disease, VPCs do not appear to have prognostic significance. Antiarrhythmic drug therapy that slows myocardial conduction can actually increase the risk of life-threatening arrhythmias (drug-induced QT prolongation and TDP) despite being effective at eliminating VPCs. These are the pros and cons of treatment of PVCs. However each case is an individual problem and therapy needs to be decided by the concerned cardiologist. Regards Dr. T.K. Biswas M.D. Mumbai